Learning disability awareness training for undergraduate midwifery students: Multi-method evaluation of a co-produced and co-delivered educational intervention in England.

BACKGROUND: Midwives lack the confidence and competence to identify and support people with learning disabilities, putting this population at risk of inequitable maternity care. OBJECTIVES: To co-produce, co-deliver and evaluate maternity focused learning disability awareness training for student midwives, in collaboration with experts-by-experience (people with learning disabilities). DESIGN: Multi-methods study evaluating the impact and acceptability of learning disability awareness training. SETTINGS: University in south-east England, UK. PARTICIPANTS: 83 midwifery students and 7 experts-by-experience. METHODS: Midwifery students completed pre-post training surveys and a follow-up survey 3 months post training to substantiate longer-term impact. Experts-by-experience took part in qualitative interviews post training. RESULTS: Student-reported learning disability awareness was significantly higher across all domains post training and sustained at follow up. Students reported the most notable aspect of training was learning with and from people with learning disabilities. Three inter-related themes were constructed from interviews with experts-by-experience: reasonable adjustments to training and research processes; a positive social, emotional and learning experience; and perceptions of impact. CONCLUSIONS: Findings from this study suggest that co-producing and co-delivering resources and education to an undergraduate midwifery workforce with people with lived experience, can have a profound impact on students and is also a positive experience for people with learning disabilities. The co-produced resources used in this training are free and accessible [https://www.surrey.ac.uk/togetherproject]. Further evaluation will explore acceptability and perceived impact of training and resources on other healthcare professionals working with maternity services.

Implementing and evaluating resources to support good maternity care for parents with learning disabilities: A qualitative feasibility study in England.

PROBLEM: Parents with learning disabilities are often disadvantaged and their needs not well understood in maternity services. BACKGROUND: Despite a global vision to improve maternity care, current evidence confirms poor pre- and post-natal care for parents with learning disabilities and their families. Midwives have expressed a need for support in the delivery of good care to this population of parents. AIM: To test the feasibility of implementing and evaluating two evidence-based and values-based resources - the Together Toolkit and Maternity Passport - to support good maternity care for people with learning disabilities. METHODS: A qualitative feasibility study employing semi-structured interviews with 17 midwives and 6 parents who had used the resources in practice in four NHS Trusts in the south of England. FINDINGS: Midwives and parents described how the resources positively impacted maternity care by enabling midwives, connecting networks and empowering parents. Factors affecting effective implementation of the resources were reported at an individual and setting level. DISCUSSION: Staff training to raise awareness and confidence in supporting parents with learning disabilities, and improved systems for recording parent's individual needs are required to enable the delivery of personalised care. CONCLUSION: Reasonable adjustments need to be prioritised to facilitate implementation of resources to support personalised maternity care and to address inequity for parents with learning disabilities. Aspirations for equity suggested commitment from midwives to challenge and overcome barriers to implementation. Recommendations were made to improve the resources and their implementation. These resources are free and accessible for use [www.surrey.ac.uk/togetherproject].